Individual provider Active NPI

Anne Rodgers-Sullivan, LCSW

  • Clinical Social Worker
  • Aurora, IL
National Provider Identifier
1215471693
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.018747 Issued in IL
Practice address
1230 N Highland Ave
Aurora, IL 60506-1401
Phone
(630) 966-4300
Fax
(630) 859-2994
NPI assigned
Dec 5, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.018747 IL Primary

Addresses

Primary practice location

1230 N Highland Ave
Aurora, IL 60506-1401

Mailing address

1230 N Highland Ave
Aurora, IL 60506-1401
Phone (630) 966-4348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170105002030 IL Practitioner - Clinical Social Worker 5698056679 Practice locations: Yorkville, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

803 N Bridge St
Yorkville, IL 60560-2155
Phone (630) 404-2055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.018747ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
This Life Counseling, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1215471693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061401",
            "telephone_number": "630-966-4348",
            "fax_number": "630-859-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061401",
            "telephone_number": "630-966-4300",
            "fax_number": "630-859-2994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS-SULLIVAN",
        "first_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-05",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.